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Table 1. AHRQ Quality Indicators Selected for the National Healthcare

National Healthcare Quality Report, 2008

Admissions for diabetes with short-term complications* (excluding obstetric admissions and transfers from other institutions) per 100,000 population, age 18 years and older * Ketoacidosis, hyperosmolarity, or coma.

PQI 3

Admissions for diabetes with long-term complications* (excluding obstetric admissions and transfers from other institutions) per 100,000 population, age 18 years and older * Renal, eye, neurological, circulatory, or other unspecified complications.

PQI 8

Admissions for congestive heart failure (excluding patients with cardiac procedures, obstetric conditions, and transfers from other institutions) per 100,000 population, age 18 years and older

PQI 14

Admissions for uncontrolled diabetes without complications* (excluding obstetric admissions and transfers from other institutions) per 100,000 population, age 18 years and older * Without short-term (ketoacidosis, hyperosmolarity, coma) or long-term (renal, eye, neurological, circulatory, other unspecified) complications.

PQI 15

Adult asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system, obstetric admissions, and transfers from other institutions) per 100,000 population, age 18 years and older

PQI 15 (modified)

Asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system, obstetric admissions and transfers from other institutions) per 100,000 population, age 65 years and older

PQI 18 (Added)

Immunization-preventable influenza admissions (excluding transfers from other institutions) per 100,000 population, age 65 years and older

Pediatric Quality Indicators

PDI 14

Pediatric asthma admissions (excluding patients with cystic fibrosis or anomalies of the respiratory system and transfers from other institutions) per 100,000 population, ages 2-17

Deaths per 1,000 admissions with abdominal aortic aneurysm (AAA) repair (excluding obstetric and neonatal admissions and transfers to another hospital), age 18 years or older

IQI 12

Deaths per 1,000 admissions with coronary artery bypass graft (excluding obstetric and neonatal admissions and transfers to another hospital), age 40 and older

IQI 15

Deaths per 1,000 admissions with acute myocardial infarction (AMI) as principal diagnosis (excluding transfers to another hospital), age 18 and older

IQI 16

Deaths per 1,000 admissions with congestive heart failure (CHF) as principal diagnosis (excluding obstetric and neonatal admissions and transfers to another hospital), age 18 and older

IQI 20

Deaths per 1,000 admissions with pneumonia as principal diagnosis (excluding obstetric and neonatal admissions and transfers to another hospital), age 18 and older

IQI 30

Deaths per 1,000 adult admissions age 40 and older with percutaneous transluminal coronary angioplasties (PTCA) (excluding obstetric and neonatal admissions and transfers to another hospital)

Patient Safety Indicators

PSI 1

Complications of anesthesia in any secondary diagnosis per 1,000 surgical discharges (excluding patients with anesthesia complications as a principal diagnosis and patients with self-inflicted injury, poisoning due to anesthetics, and active drug dependence or abuse), age 18 years or older or obstetric admissions

PSI 2

Deaths per 1,000 admissions in low mortality DRGs (DRGs with a NIS 1997 benchmark of less than 0.5% mortality, excluding trauma, immunocompromised, and cancer patients), age 18 years or older or obstetric admissions

PSI 3

Decubitus ulcers per 1,000 discharges of length 5 or more days (excluding transfers, patients admitted from long-term-care facilities, patients with diseases of the skin, subcutaneous tissue, and breast, and obstetrical admissions*), age 18 years or older * Also excludes admissions specifically for decubitus ulcers, such as cases from earlier admissions or from other hospitals.

PSI 4

Failure to rescue or deaths per 1,000 discharges having developed specified complications of care during hospitalization (excluding patients transferred in or out, patients admitted from long-term-care facilities), age 18 years to 74 years

PSI 5

Foreign body accidentally left in during procedure per 1,000 medical and surgical discharges*, age 18 years or older or obstetric admissions * Also excludes admissions specifically for treatment of foreign body left, such as cases from earlier admissions or from other hospitals.

PSI 6

Iatrogenic pneumothorax per 1,000 discharges (excluding obstetrical admissions and patients with chest trauma, thoracic surgery, lung or pleural biopsy, or cardiac surgery*), age 18 years or older * Also excludes admissions specifically for iatrogenic pneumothorax, such as cases from earlier admissions or from other hospitals. Includes barotrauma (including acute respiratory distress syndrome) and central line placement.

PSI 7

Selected infections due to medical care per 1,000 medical and surgical discharges (excluding immunocompromised and cancer patients, stays under 2 days, and admissions specifically for such infections*), age 18 years or older or obstetric admissions * Also excludes admissions specifically for such infections, such as cases from earlier admissions, from other hospitals, or from other settings.

Postoperative hemorrhage or hematoma with surgical drainage or evacuation, not verifiable as following surgery*, per 1,000 surgical discharges (excluding obstetrical admissions), age 18 years or older * Postoperative hemorrhage or hematoma is not verifiable as following surgery because information on day of procedure is not available for all discharges. Also, excludes admissions specifically for such problems, such as cases from earlier admissions, from other hospitals, or from other settings.

PSI 10

Postoperative physiologic and metabolic derangements per 1,000 elective surgical discharges (excluding some serious disease* and obstetric admissions), age 18 years and older * That is, excluding patients with diabetic coma and patients with renal failure who also were diagnosed with AMI, cardiac arrhythmia, cardiac arrest, shock, hemorrhage, or gastrointestinal hemorrhage.

Postoperative pulmonary embolus (PE) or deep vein thrombosis (DVT) per 1,000 surgical discharges (excluding patients admitted for DVT, obstetrics, and plication of vena cava before or after surgery*), age 18 years or older * Also excludes admissions specifically for such thromboembuli, such as cases from earlier admissions, from other hospitals, or from other settings.

PSI 13

Postoperative sepsis per 1,000 elective-surgery discharges with an operating room procedure (excluding patients admitted for infection; patients with cancer or immunocompromised states, obstetric conditions, stays under 4 days, and admissions specifically for sepsis), age 18 years or older

PSI 14

Reclosure of postoperative abdominal wound dehiscence per 1,000 abdominopelvic-surgery discharges (excluding immunocompromised patients, stays under 2 days, and obstetric conditions*), age 18 years or older * Also excludes admissions specifically for such wound dehiscence, such as cases from earlier admissions or from other hospitals.

PSI 15

Accidental puncture or laceration during procedures per 1,000 discharges (excluding obstetric admissions*), age 18 years or older * Also excludes admissions specifically for such problems, such as cases from earlier admissions or from other hospitals.

PSI 16

Transfusion reactions per 1,000 discharges, age 18 years or older or obstetric admissions* * Also excludes admissions specifically for transfusion reactions, such as cases from earlier admissions or from other hospitals.